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Workers compensation monthly report

March 2019 report

Accessible version

System overview

Key workers compensation system statistics for the 12 months ending March 2019

$257 billion of reported wages are safeguarded by the workers compensation scheme

$3.5 billion in premiums were collected, representing 1.4% of reported NSW wages1

$2.9 billion was paid out as costs for workers claims

103,918 claims were reported to SIRA

76,658 workers received weekly benefit payments

1For the 2017/18 financial year

Effectiveness

System effectiveness in protecting workers and getting workers back to work and wellbeing

Reportable claims

10,274 were reported in March 2019

9,562 were reported in February 2019

8,617 were reported in March 2018

Claim types

Of the 10,274 reportable claims in March 2019, 92.6% (9,518) were related to physical injuries and 7.4% (756) were related to psychological injuries.

Claims by body locations

Head: 9.8%

Neck: 2.6%

Upper limbs: 32.8%

Trunk: 19.7%

Lower limbs: 19.8%

Also:

Psychological: 7.4%

Multiple locations: 3.1%

To be confirmed: 3.5%

Systemic locations: 1.3%

Effectiveness

Workers’ claims journey results at March 2019

Monthly average over the last 12 months

11,370 records submittedA^

8,660 reportable claims ^

3,442 lost timeT^

A Records submitted includes all records received from insurers across NSW. This data excludes administration errors.

^ Figure is based on a 12 month average.

T Lost time is based on workers receiving weekly benefits.

Return to work

61.0% at 4 weeks*

76.3% at 13 weeks*

84.7% at 26-weeks*

Note: SIRA identified data quality issues with the accuracy and completeness of return to work data submitted by the Nominal Insurer (NI). The data appears to indicate a significant deterioration in the NI’s RTW performance. SIRA instructed the NI to improve the quality of the data. To address the data quality and potential performance concerns with the NI, SIRA carried out a data quality audit in December 2018 and commenced a Compliance and Performance Review in February 2019. 

* Based on a rolling 12 month cohort, for further details see the Explanatory Note.

Efficiency & viability

Efficient system delivery, sustainability, and viability of the system for generations to come

Total claim payments made by insurers

In March 2019, the Nominal insurer made payments of over $165 million, Government self-insurers (TMF) of nearly $50 million, self-insurers of over $16 million and specialised insurers of nearly $12 million.

Claim payment types

The breakdown of claim payment types in March 2019 is as follows:

  • Weekly payments: 39.8%
  • Medical payments: 29.3%
  • Common law (WID): 13.1%
  • Rehabilitation payments: 4.8%
  • Lump sum (S66 & S67) payments: 4.9%
  • Death payments: 1.2%
  • Investigation payments: 2.4%
  • Other payments: 2.1%
  • Legal payments: 1.7%
  • Commutations: 0.5%

Total claim payments made by insurers

In March 2019 $243 million dollars payed in claim payments.

In February 2019 $232 million dollars payed in claim payments.

Up 4.8% based on data provided by insurers at the end of March 2019. Please note this may increase should late running reports of payments be supplied by insurers after the March data submission.

Benefits paid to and for workers as a percentage of total claims expenditure

Of the total expenditure across the system in 2017/18, 45% was made on payments to claimants and 24% was spent to make payments for the claimants. Insurer expenses across the system was 31% of the total expenditure.

Note: The benefits paid to and for workers is calculated annually. Details of definitions can be found in the methodology and data section. Data sourced from the information insurers provide to SIRA as at the financial year 2017/18.

Customer experience & equity

Customers’ experience with the system is positive and equitable

Enquiries and complaints

SIRA received 2,484 enquiries in March 2019. There were 513 complaints received in the same period.

Note: Complaint data (which may include the name of an insurer) is derived from verbatim reports from customers. While SIRA does some data cleansing, the reporting is verbatim from customers and might occasionally reference an incorrect insurer and/or insurer type.

Disputes lodged

In March 2019, the dispute rate was 0.7%, with 86,937 active claims and 589 disputes lodged.

Note: Including data from the Workers Compensation Commission.

Workers perceptions of equity across the workers compensation system

Workers perceptions of equity across the workers compensation system
Jurisdiction Distributive Justice
Average (mean) on a 5 point scale
Procedural Justice
Average (mean) on a 5 point scale
Informational Justice
Average (mean) on a 5 point scale
Interpersonal Justice
Average (mean) on a 5 point scale
New South Wales 3.9 3.8 3.7 4.3
Australian Total 3.9 3.8 3.7 4.3

Definitions of dimensions used to measure customers perception of equity and perceived justice:

  • Distributive justice, relates to the fairness of their compensation.
  • Informational justice, is about receiving accurate and timely information about the rationale for decisions.
  • Interpersonal justice, relates to whether workers were treated with respect and sensitivity.
  • Procedural justice, about the fairness of the procedures used to determine the outcomes.

Source: Safe Work Australia 2018 Return to Work Survey.

Affordability

Insurance affordability

The affordability of insurance is 1.4% of reported NSW wages for 2017/18.

NSW workers compensation insurer scorecard

Information about the performance of insurers operating within the workers compensation system

NSW workers compensation insurer scorecard
  % share of reported wages
FY 2017/18
% share of total claims
FY 2017/18
% share of total payments made % share of total active claims % of injury notifications actioned within 7 days % of Level 1 complaints to active claims RTW rate
4 weeks
RTW rate
13 weeks
RTW rate
26 weeks
Nominal Insurer 74% 67% 68% 64% 74% 0.1% 56% 73% 84%
Government self-insurer (TMF) 13% 16% 20% 21% 100% 0.0% 75% 85% 89%
Specialised Insurers 6% 8% 5% 7% 96% 0.0% 74% 83% 86%
Self insurers 7% 9% 7% 8% 98% 0.0% 65% 77% 82%

Note: Insurers reported this data to SIRA. Data is as at March 2019.

Disclaimer: While reasonable care has been taken in preparing this document, the State Insurance Regulatory Authority (SIRA) makes no warranties of any kind about its accuracy, currency or suitability for any particular purpose. SIRA disclaims liability for any kind of loss or damages arising from, or in connection with, the use of any information in this document.

SIRA identified data quality issues with the accuracy and completeness of return to work data submitted by the Nominal Insurer (NI). The data appears to indicate a significant deterioration in the NI’s RTW performance. SIRA instructed the NI to improve the quality of the data. To address the data quality and potential performance concerns with the NI, SIRA carried out a data quality audit in December 2018 and commenced a Compliance and Performance Review in February 2019.

Additional scheme performance measures

Information about the performance of insurers operating within the workers compensation system

Cost to the scheme for weekly benefits paid per month

In March 2019, the total amount of weekly benefit payments paid by insurer type was:

$64 million by the Nominal insurer

$23 million by the Government self-insurer (TMF)

$5 million by self-insurers

$4 million by specialised insurers

Note: To ensure consistency across the time series, the data excludes Section 39 claimants that exited the system.

Number of workers receiving weekly benefits per month

In March 2019, the number of workers receiving weekly benefits by insurer type was:

17,435 by the Nominal insurer

6,594 by the Government self-insurer (TMF)

1,788 by self insurers

1,289 by specialised insurers

Note: To ensure consistency across the time series, the measure excludes Section 39 claimants that exited the system. The chart shows distinct number of workers receiving weekly benefits per month.

RTW including medical only claimants rate

In March 2019, the 4 week RTW rate was:

75% for the Nominal insurer

83% for the Government self-insurer (TMF)

84% for specialised insurers

86% for self insurers

78% for the system average

In March 2019, the 13 week RTW rate was:

85% for the Nominal insurer

89% for the Government self-insurer (TMF)

89% for specialised insurers

89% for self insurers

86% for the system average

In March 2019, the 26 week RTW rate was:

90% for the Nominal insurer

92% for the Government self-insurer (TMF)

90% for specialised insurers

91% for self insurers

90% for the system average

Note: The percentage of workers at work at 4, 13, and 26 weeks is a variation of the RTW work measure reported on pages 2 and 5 of the dashboard. This measure includes medical only claims who never left work and allows an insurer type comparison of workers who are at work at 4, 13 and 26 week intervals from the date the claims entered the system. See the “Data source information” section of the Explanatory note for further details on the percentage of workers at work measure.

Average duration of weekly benefits paid in the first 6 months

In September 2018, the average was:

29 days for the Nominal insurer

27 days for the Government self-insurer (TMF)

18 days for specialised insurers

15 days for self insurers

Note: This measure shows the average number of days of weekly benefits paid to injured workers in the first 6 months of their claim. This measure uses work hours lost and injury quarter to calculate average days, it is reported to September 2018 to allow for claim data development. See the “Data source information” section of the Explanatory note for further details on the average duration of weekly benefits paid in the first 6 months measure.

Reportable claims development

Total reportable claims by financial year at 9 development periods

63,153 in 2015/16

63,402 in 2016/17

63,968 in 2017/18

72,461 in 2018/19

Claim payments development

Total claim payments by financial year at 9 development periods

$289 million in 2015/16

$336 million in 2016/17

$361 million in 2017/18

$367 million in 2018/19

Note: The reportable claims development chart visualises the development of reportable claims by injury financial year. Displaying reportable claims by injury financial year, across development months from claim injury date, helps to track variations in figures and also benchmark against previous injury financial years. The claim payments development chart visualises the development of claim payments by injury financial year. Displaying claim payments by injury financial year, across development months from claim injury date, allows for system payment comparisons. No indexation or adjustments have been applied to payment figures, the chart shows original dollar values.

Download the report (PDF, 429 KB) and the methodology and summary data tables (Excel worksheet, 280 KB) used to support this report. If you have trouble accessing content within these reports, please send an email to contact@sira.nsw.gov.au or call us on 13 10 50.